| NPI | 1578883062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A127307) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A127307) |
| 207Q00000X Family Medicine (Licence: NV 17726) | |
| 207Q00000X Family Medicine (Licence: PA resident in training) | |
| 207Q00000X Family Medicine (Licence: FL ME114155) | |
| 208M00000X Hospitalist (Licence: ID M-14898) | |
| 208M00000X Hospitalist (Licence: UT 11403875-1205) | |
| 208M00000X Hospitalist (Licence: NV 17726) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2022-03-23 |