| NPI | 1033370176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 61897) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N4805) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2023-11-27 |