| NPI | 1336192715 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00020218) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00020218) | 
| Enumeration Date | 2006-05-18 | 
| Last Update Date | 2021-03-25 |