| NPI | 1053976423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V0657) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: IL 036161316) | |
| 207R00000X Internal Medicine (Licence: IL 036161316) | |
| 207R00000X Internal Medicine (Licence: TX V0657) | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2026-01-06 |