| NPI | 1487217345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 60041526) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA OP61273998) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2026-06-09 |