| NPI | 1760846240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 83657) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 83657) |
| 207R00000X Internal Medicine (Licence: WA MD60965860) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-07-23 |