| NPI | 1235458076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N5259) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX N5259) |
| 208M00000X Hospitalist (Licence: TX N5259) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2024-09-19 |