| NPI | 1467716530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A150215) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A150215) |
| 207Q00000X Family Medicine (Licence: NC 184103) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2023-06-28 |