| NPI | 1508151127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A127130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A127130) |
| 207R00000X Internal Medicine (Licence: CA A127130) | |
| Enumeration Date | 2011-06-11 |
| Last Update Date | 2017-10-13 |