| NPI | 1396754925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A9624) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9624) |
| 207R00000X Internal Medicine (Licence: CA 20A9624) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2018-12-14 |