| NPI | 1104289883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 13342669-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID O-1277) |
| 207Q00000X Family Medicine (Licence: UT 13342669-1204) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-11-16 |