| NPI | 1336133024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 3871) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L7833) |
| 207Q00000X Family Medicine (Licence: OK 3871) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2019-06-21 |