| NPI | 1790210466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61073740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61073740) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2020-07-28 |