| NPI | 1407059058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-88718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60199078) |
| 208M00000X Hospitalist (Licence: WA MD60199078) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-04-06 |