| NPI | 1912203696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T4944) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SD 8095) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2024-01-05 |