| NPI | 1760914089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA 61260762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 60563) |
| 207R00000X Internal Medicine (Licence: WA 61260762) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-03-24 |