| NPI | 1841676541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61218214) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 69307) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2023-04-07 |