| NPI | 1316146665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A111795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 5601) |
| 207Q00000X Family Medicine (Licence: CA A111795) | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2017-01-24 |