| NPI | 1730507401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60758195) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60758195) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-11-12 |