| NPI | 1861769663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0636) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX Q0636) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2024-11-19 |