| NPI | 1174675524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60166611) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60166611) |
| 208M00000X Hospitalist (Licence: CO 33008) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2011-10-27 |