| NPI | 1073046579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX s1237) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S1237) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2020-07-27 |