| NPI | 1124246350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A89569) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A89569) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-12-06 |