| NPI | 1619123775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S6591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S6591) |
| 208M00000X Hospitalist (Licence: MD D73078) | |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2022-03-11 |