| NPI | 1447693585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C198690) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: TX R1760) | |
| 207Q00000X Family Medicine (Licence: NM MD2016-0654) | |
| 208M00000X Hospitalist (Licence: TX R1760) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-12-23 |