| NPI | 1275885147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 53799) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 53799) |
| 208M00000X Hospitalist (Licence: WA MD60572904) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2022-06-12 |