| NPI | 1962886390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60861197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60861197) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2026-04-13 |