| NPI | 1679929939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S3380) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 1677992939) |
| 207R00000X Internal Medicine (Licence: TX S3380) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-07-31 |