| NPI | 1790179372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A152045) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A152045) |
| 208M00000X Hospitalist (Licence: CA A152045) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-08-18 |