| NPI | 1255436432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00039777) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA 39777) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2019-12-11 |