| NPI | 1982814596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA OP60084780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R7862) |
| 208M00000X Hospitalist (Licence: CA 12383) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-12-17 |