| NPI | 1861071375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD.61469713) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD61469713) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2025-03-04 |