| NPI | 1952619876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 43764) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 43764) |
| 207R00000X Internal Medicine (Licence: TX P6626) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2019-10-11 |