| NPI | 1831131820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA04652) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX PA04652) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-09-29 |