| NPI | 1073742193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A105641) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A105641) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2014-03-17 |