| NPI | 1306842935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P3152) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD200147) |
| 208M00000X Hospitalist (Licence: LA 200147) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2023-12-27 |