| NPI | 1215315007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A18141) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A18141) |
| 207R00000X Internal Medicine (Licence: CO 56563) | |
| 208M00000X Hospitalist (Licence: CO 0056563) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2022-10-31 |