| NPI | 1174961734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60629022) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60629022) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2025-10-10 |