| NPI | 1174973937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S1187) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10056692) |
| 207Q00000X Family Medicine (Licence: TX S1187) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2023-01-17 |