| NPI | 1841347242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M5599) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX M5599) |
| 208M00000X Hospitalist (Licence: TX M5599) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-03-01 |