| NPI | 1851561203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A113872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 046198) |
| 207Q00000X Family Medicine (Licence: CA A113872) | |
| 207R00000X Internal Medicine (Licence: CA A113872) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2019-03-19 |