| NPI | 1619265337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P9557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 30523) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2022-10-13 |