| NPI | 1326090804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA G078059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2784) |
| 207Q00000X Family Medicine (Licence: CA G78059) | |
| 207R00000X Internal Medicine (Licence: CA G078059) | |
| 208D00000X General Practice (Licence: CA G078059) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2022-04-29 |