| NPI | 1205280914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP61052999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP61052999) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-05-07 |