| NPI | 1215171103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S1545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 122361) |
| 207R00000X Internal Medicine (Licence: LA 334336) | |
| 207R00000X Internal Medicine (Licence: TX S1545) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2023-03-14 |