| NPI | 1962470138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD00043157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD21256) |
| 207R00000X Internal Medicine (Licence: MO 2022008699) | |
| 208M00000X Hospitalist (Licence: AK 237095) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2025-07-29 |