| NPI | 1982840393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N4228) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX N4228) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX N4228) | |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2024-02-08 |