| NPI | 1699757237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L8337) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX L8337) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-10-18 |