| NPI | 1093762940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J6057) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX J6057) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-11-25 |