| NPI | 1740574581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T5760) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60652453) |
| 207Q00000X Family Medicine (Licence: CO CDR.0001960) | |
| 208M00000X Hospitalist (Licence: WA MD60652453) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2024-04-03 |