| NPI | 1710083886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00019743) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA 19743) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2015-02-13 |