| NPI | 1790951531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60143680) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60143680) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2020-04-09 |