| NPI | 1750640249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0176) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 31301) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2024-10-16 |