| NPI | 1558063677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A24075) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A24075) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: CA 20A24075) | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2026-06-12 |