| NPI | 1194106039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP60536310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP 60536310) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-06-24 |