| NPI | 1295065142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX m7965) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 52669) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2026-07-13 |