| NPI | 1790122307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C177218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-8946) |
| 208M00000X Hospitalist (Licence: OH 35.129314) | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2023-12-19 |