| NPI | 1851557201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 62758) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P0573) |
| 207Q00000X Family Medicine (Licence: AZ 62758) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2021-11-17 |