| NPI | 1194724609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P3780) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 30852) |
| 208M00000X Hospitalist (Licence: TX P3780) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-04-06 |