| NPI | 1619463189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036155222) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD.MD.70080965) |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2026-07-02 |