| NPI | 1104888361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00035345) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00035345) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-05-08 |