| NPI | 1922493675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 118626) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: TX BP10052485) |
| 208M00000X Hospitalist (Licence: TX R4721) | |
| 208M00000X Hospitalist (Licence: AK 161438) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-08-22 |