| NPI | 1780649905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M8865) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX M8865) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-09-10 |