| NPI | 1982896361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60335778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60335778) |
| 207R00000X Internal Medicine (Licence: MD D72514) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2020-07-30 |