| NPI | 1912313420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S0814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11017636A) |
| 207Q00000X Family Medicine (Licence: TX S0814) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2023-09-07 |