| NPI | 1114922713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L4072) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301065426) |
| 208M00000X Hospitalist (Licence: MI 4301065426) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2014-05-01 |