| NPI | 1114148285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A97890) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A97890) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-07-21 |