| NPI | 1982047551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q9573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q9573) |
| 207R00000X Internal Medicine (Licence: TX BP10046654) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-06-06 |