| NPI | 1043683824 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T2012) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 270020) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-11-03 | 
| Last Update Date | 2022-03-22 |