| NPI | 1619129624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7181) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX N7181) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2013-06-06 |