| NPI | 1215208285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P8979) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P8979) |
| 207R00000X Internal Medicine (Licence: FL ME114105) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2020-03-21 |