| NPI | 1619132834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 9596330-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 9596330-1205) |
| 207Q00000X Family Medicine (Licence: WI 52440-020) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2022-07-21 |