| NPI | 1558442962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L6813) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 04-25776) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-04-11 |