| NPI | 1053315598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX H9984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H9984) |
| 208M00000X Hospitalist (Licence: TX H9984) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2023-10-19 |