| NPI | 1477588192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX L3528) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L3528) |
| 207P00000X Emergency Medicine (Licence: CA A88300) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-03-07 |