| NPI | 1912528464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U2439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10070651) |
| 208D00000X General Practice (Licence: TX U2439) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-08-15 |