| NPI | 1679007827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61169341) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A174016) |
| 207R00000X Internal Medicine (Licence: WA MD61169341) | |
| 207R00000X Internal Medicine (Licence: NV 20610) | |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2023-04-27 |