| NPI | 1649474222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N2730) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N2730) |
| 208D00000X General Practice (Licence: TX N2730) | |
| 208M00000X Hospitalist (Licence: TX N2730) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-07-06 |