| NPI | 1932192929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N1859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 2002-0378) |
| 207R00000X Internal Medicine (Licence: TX N1859) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2022-11-15 |