| NPI | 1710411798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U0586) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS019774) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2023-02-21 |