| NPI | 1902863731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX J8905) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX J8905) |
| 207R00000X Internal Medicine (Licence: AZ 33432) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-09-30 |