| NPI | 1952421166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX M1060) |
| Additional Taxonomies | 282E00000X Long Term Care Hospital (Licence: TX M1060) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-05-22 |