| NPI | 1093132383 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX R3942) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R3942) | 
| 207R00000X Internal Medicine (Licence: TX R3942) | |
| Enumeration Date | 2014-03-25 | 
| Last Update Date | 2024-09-19 |