| NPI | 1851321558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L9102) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 15958) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2026-01-28 |