| NPI | 1205063534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A12842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A128342) |
| 208D00000X General Practice (Licence: CA A128342) | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2022-02-03 |