| NPI | 1184989980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A139223) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A139223) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2022-04-22 |