| NPI | 1346636586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V2420) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: TX V2420) | |
| 207Q00000X Family Medicine (Licence: IA MD-45860) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2024-12-17 |