| NPI | 1518126309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N1085) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N1085) |
| 208M00000X Hospitalist (Licence: HI E14821) | |
| 207R00000X Internal Medicine (Licence: HI E14821) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2012-09-26 |