| NPI | 1366705139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q2983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q2983) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2019-12-11 |