| NPI | 1710189097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N3749) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N3749) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-09-17 |