| NPI | 1497742746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M8998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 50460) |
| 207Q00000X Family Medicine (Licence: TX M8998) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2021-11-16 |