| NPI | 1437776085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U9286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9286) |
| 208D00000X General Practice (Licence: TX U9286) | |
| 208D00000X General Practice (Licence: MI 4351047267) | |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2024-10-21 |