| NPI | 1255726261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A159135) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 62378) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2024-02-16 |