| NPI | 1013245000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 7730028-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2012003966) |
| 208M00000X Hospitalist (Licence: MO 2012003966) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2017-11-16 |