| NPI | 1902817869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK MEDS3968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 3968) |
| 207R00000X Internal Medicine (Licence: WA MD32612) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WA MD32612) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AK 3968) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2019-04-26 |