| NPI | 1710995808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00020433) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00020433) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2010-05-05 |