| NPI | 1093163222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A17411) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT017019) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2020-08-03 |