| NPI | 1669669339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A105886) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: CA A105886) |
| 208M00000X Hospitalist (Licence: CA A105886) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2022-07-19 |