| NPI | 1174750335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60575477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT 47189) |
| 207R00000X Internal Medicine (Licence: WA MD60575477) | |
| 207R00000X Internal Medicine (Licence: OR MD161200) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2026-01-27 |