| NPI | 1710996707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 05887) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 162266-1205) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-07-15 |