| NPI | 1366737694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60728171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2013-0762) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2021-04-27 |