| NPI | 1679070080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO213361) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA OP61161603) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2024-04-19 |