| NPI | 1104203207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD.MD.70111331) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD.MD.70111331) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2026-07-21 |