| NPI | 1518970904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K4821) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX K4821) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2019-10-13 |