| NPI | 1962456368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60260387) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA md00043514) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2021-04-28 |