| NPI | 1598926164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U0404) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U0404) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: TX UO404) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2025-04-11 |