| NPI | 1255514279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M7860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M7860) |
| 208M00000X Hospitalist (Licence: TX M7860) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2023-02-02 |