| NPI | 1043731961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S4467) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018003) |
| 207R00000X Internal Medicine (Licence: TX S4467) | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2025-12-15 |