| NPI | 1487174470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61065534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61065534) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2020-08-14 |