| NPI | 1952612350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX P9054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18638) |
| 207R00000X Internal Medicine (Licence: PR 29812) | |
| 207R00000X Internal Medicine (Licence: TX P9054) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-06-20 |