| NPI | 1649405226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60342809) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60342809) |
| 208000000X Pediatrics (Licence: WA MD60342809) | |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2026-01-29 |