| NPI | 1891946570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP60279981) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60279981) |
| 207R00000X Internal Medicine (Licence: OH 34) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2020-11-11 |