| NPI | 1639819816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP61574145) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP61574145) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-09-29 |