| NPI | 1952965097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP61302767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R3112) |
| 207R00000X Internal Medicine (Licence: WA OP61302767) | |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2023-01-24 |