| NPI | 1164613634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A10114) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CA 20A10114) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2013-04-30 |