| NPI | 1962843979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-49760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61235822) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2025-05-15 |