| NPI | 1235495292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P8439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10042710) |
| 208000000X Pediatrics (Licence: TX BP10042710) | |
| 208M00000X Hospitalist (Licence: TX P8439) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2021-10-18 |