| NPI | 1851562946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60134149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60134149) |
| 207R00000X Internal Medicine (Licence: OH 35-094040) | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2010-11-22 |