| NPI | 1902056971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P6266) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P6266) |
| 207R00000X Internal Medicine (Licence: IL 125054687) | |
| 208M00000X Hospitalist (Licence: CO DR.0054493) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2020-10-16 |