| NPI | 1164566659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00023315) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00023315) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2021-04-07 |