| NPI | 1467915264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T9331) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX T9331) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-06-15 |