| NPI | 1750638763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60445797) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60445797) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2020-04-30 |