| NPI | 1912291873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60677086) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60677086) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2020-01-31 |