| NPI | 1326394693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX 9674228-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 15225) |
| 207Q00000X Family Medicine (Licence: UT 9674228-1205) | |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2022-07-21 |