| 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 |