| NPI | 1255352829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP00001637) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP00001637) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-03-04 |