| NPI | 1326151523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX J8455) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J8455) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: TX J8455) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-01-24 |