| NPI | 1316139660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 26163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 26163) |
| 207R00000X Internal Medicine (Licence: TX V2052) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2024-09-11 |