| NPI | 1992231468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S6395) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S6395) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2020-06-29 |