| NPI | 1700231099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S2322) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2019-0599) |
| 207R00000X Internal Medicine (Licence: TX S2322) | |
| 208M00000X Hospitalist (Licence: TX S2322) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2025-01-30 |