| NPI | 1548204019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD00046205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00046205) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-05-05 |