| NPI | 1205254224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A140668) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A140668) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-12-17 |