| NPI | 1588140008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A173243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA PTL170) |
| 208D00000X General Practice (Licence: CA PLT170) | |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2023-10-20 |