| NPI | 1053773804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T1629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T1629) |
| 207R00000X Internal Medicine (Licence: PA MD468060) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-01-25 |