| NPI | 1780634857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A86771) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A86771) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-10-20 |