| NPI | 1982861050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N7104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 048404) |
| 207Q00000X Family Medicine (Licence: TX N7104) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2014-11-26 |