| NPI | 1972034494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61084215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A163024) |
| 207R00000X Internal Medicine (Licence: WA MD61084215) | |
| Enumeration Date | 2017-03-26 |
| Last Update Date | 2021-04-08 |