| NPI | 1790750214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD16622) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD16622) |
| 207R00000X Internal Medicine (Licence: WA MD00044947) | |
| Enumeration Date | 2006-02-19 |
| Last Update Date | 2021-06-18 |