| NPI | 1285194662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2022-02050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61200401) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2022-09-20 |