| NPI | 1750581559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 13557) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 13557) |
| 207Q00000X Family Medicine (Licence: CA A110377) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2021-03-31 |