| NPI | 1003812785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T8836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101056188) |
| 208M00000X Hospitalist (Licence: VA 0101056188) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-05-26 |