| NPI | 1558527846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P4300) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 00000) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2021-01-04 |