| NPI | 1043614860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD453092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35125652) |
| 207R00000X Internal Medicine (Licence: TX T5415) | |
| 208M00000X Hospitalist (Licence: TX T5415) | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2023-09-12 |