| NPI | 1578970463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A130975) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 130975) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2019-10-18 |