NPI | 1841255056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A22842) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 22842) |
207Q00000X Family Medicine (Licence: KS 05-32303) | |
Enumeration Date | 2006-04-19 |
Last Update Date | 2024-10-15 |