| NPI | 1164409553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N9356) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 3764221205) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2012-06-19 |