| NPI | 1942454061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60851134) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 26219) |
| 207R00000X Internal Medicine (Licence: WA MD60851134) | |
| 208M00000X Hospitalist (Licence: OK 26219) | |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2021-08-17 |