| NPI | 1871545293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N4277) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-11647) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: LA 200539) | |
| 207R00000X Internal Medicine (Licence: LA 200539) | |
| 208M00000X Hospitalist (Licence: AR E-11647) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-03-25 |