| NPI | 1912263260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C169402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64319-20) |
| 208M00000X Hospitalist (Licence: WI 64319-20) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2021-05-10 |