| NPI | 1295269264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20a16928) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 20A16928) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2022-08-31 |