| NPI | 1912165788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11917018-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A113810) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2021-08-16 |