| NPI | 1235371675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107046) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60335318) |
| 208000000X Pediatrics (Licence: WA MD60335318) | |
| 208M00000X Hospitalist (Licence: WA MD60335318) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-10-21 |