| NPI | 1588982888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60995770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID m-12525) |
| 208M00000X Hospitalist (Licence: ID M-12525) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2026-04-03 |