| NPI | 1023543170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T4401) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: TX T4401) | |
| 207R00000X Internal Medicine (Licence: IN 01083705A) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2026-08-28 |