| NPI | 1821253568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C144332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD443136) |
| 207Q00000X Family Medicine (Licence: OH 57014374) | |
| 207Q00000X Family Medicine (Licence: CA C144332) | |
| 208M00000X Hospitalist (Licence: PA MD443136) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2021-02-16 |