| NPI | 1104805902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L4709) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 225106) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2023-06-16 |