| NPI | 1780946566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P8738) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS21363) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2024-10-08 |