| NPI | 1639819634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 21898) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 21898) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2025-08-19 |