| NPI | 1720400971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A144500) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A144500) |
| 207Q00000X Family Medicine (Licence: CA 144500) | |
| 207R00000X Internal Medicine (Licence: CA A144500) | |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2024-09-09 |