| NPI | 1922078120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L5220) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 047876) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-01-07 |