| NPI | 1982066544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61154767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61154767) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-06-08 |