| NPI | 1821613522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T4653) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T4653) |
| 207Q00000X Family Medicine (Licence: TX BP10070629) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2023-10-18 |