| NPI | 1063767598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P1033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1033) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX p1033) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2022-07-21 |