| NPI | 1518970904 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX K4821) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K4821) | 
| Enumeration Date | 2006-08-15 | 
| Last Update Date | 2024-09-12 |