| NPI | 1285047027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-02124) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2017-02124) |
| 207Q00000X Family Medicine (Licence: TX Bp10049150) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-02-10 |