| NPI | 1720178841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C54077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301077841) |
| 207Q00000X Family Medicine (Licence: CA C54077) | |
| 207R00000X Internal Medicine (Licence: CA C54077) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-10-04 |