| NPI | 1790943900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A103721) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 48268) |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2023-10-04 |