| NPI | 1407964158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M4160) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX M4106) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-07-26 |