| NPI | 1265424741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11262404-1204) |
| 207Q00000X Family Medicine (Licence: TX L5966) | |
| 208M00000X Hospitalist (Licence: UT 11262404-1204) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2022-01-28 |