| NPI | 1619018066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A41494) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME 016873) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2024-06-03 |