| NPI | 1417390956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2016015181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2016015181) |
| 207Q00000X Family Medicine (Licence: CA A132944) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-05-30 |