| NPI | 1912327032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60877059) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD178536) |
| 207R00000X Internal Medicine (Licence: WA MD60877059) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2019-12-10 |