| NPI | 1164490470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX K7073) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX K7073) |
| 207Q00000X Family Medicine (Licence: TX K7073) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2020-03-13 |