| NPI | 1578060737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T8160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A164190) |
| 207Q00000X Family Medicine (Licence: TX T8160) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2022-12-06 |