| NPI | 1053657783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 69512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R5419) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2025-02-05 |