| NPI | 1861752826 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX BP10043181)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60595326)  | 
| 208M00000X Hospitalist (Licence: WI 64116-20)  | |
| 208M00000X Hospitalist (Licence: WA MD60595326)  | |
| Enumeration Date | 2012-05-24 | 
| Last Update Date | 2021-12-08 |