| NPI | 1043731961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S4467) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S4467) |
| 207R00000X Internal Medicine (Licence: NM A-2365-20) | |
| 207R00000X Internal Medicine (Licence: PA OT018003) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2023-10-19 |