| NPI | 1215169511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 9740416-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301101217) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2018-09-28 |