| NPI | 1992947063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60523820) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 55142) |
| 207R00000X Internal Medicine (Licence: WA MD60523820) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2023-05-09 |