| NPI | 1104182757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60741581) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 15365) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2023-12-28 |