| NPI | 1013913623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX J2627) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX J2627) |
| 207R00000X Internal Medicine (Licence: TX J2627) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2021-03-01 |