| NPI | 1841647104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61170590) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61170590) |
| 207R00000X Internal Medicine (Licence: MD P32579) | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2024-08-15 |