| NPI | 1720212608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P4687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10033958) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2016-05-27 |