| NPI | 1427442839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 6585019-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL uo4720) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2019-09-11 |