| NPI | 1821005539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M9289) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 232973) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TX M9289) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2018-10-11 |