| NPI | 1689600165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60105620) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60105620) |
| 208M00000X Hospitalist (Licence: WA MD60105620) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2021-05-18 |