| NPI | 1366797524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60613593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2015-01582) |
| 207R00000X Internal Medicine (Licence: WA MD60613593) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2021-11-10 |