| NPI | 1134200496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA md00041061) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00041061) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-09-20 |