| NPI | 1053766303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 31738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10055775) |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2019-07-03 |