| NPI | 1174728026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1687) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 257074) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2017-02-14 |