| NPI | 1659392512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00040225) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00040225) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2011-06-03 |