| NPI | 1780792234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A65065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A65065) |
| 207R00000X Internal Medicine (Licence: CA A65065) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2018-09-26 |