| NPI | 1689938797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 078275) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 078275) |
| 207R00000X Internal Medicine (Licence: TX Q4691) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2018-03-17 |