| NPI | 1346778644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T2425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2425) |
| 207Q00000X Family Medicine (Licence: LA 324060) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2026-09-30 |