| NPI | 1730135690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60189235) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60189235) |
| 207R00000X Internal Medicine (Licence: WA MD60189235) | |
| 207R00000X Internal Medicine (Licence: NC 9701056) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2018-10-01 |