| NPI | 1154675585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A123513) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A123513) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2018-11-02 |