| NPI | 1871527440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 5755314-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 5755314-1205) |
| 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: UT 5755314-1205) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-11-27 |