| NPI | 1295478816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A190785) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A190785) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2025-08-29 |