| NPI | 1942863170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T8780) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX T8780) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2024-11-12 |