| NPI | 1184888554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60164531) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60164531) |
| 207R00000X Internal Medicine (Licence: HI MD15801) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-03-30 |