| NPI | 1003217977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 13523114-1235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R2744) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2024-06-05 |