| NPI | 1801089214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 6681723-1205) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 6681723-1205) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-07-13 |