| NPI | 1114370186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61420795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 62960) |
| 208M00000X Hospitalist (Licence: CT PENDING) | |
| 208M00000X Hospitalist (Licence: CT 62960) | |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2023-08-28 |