| NPI | 1063031086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W0015) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: AR E-16761) | |
| 208M00000X Hospitalist (Licence: LA 337143) | |
| 207R00000X Internal Medicine (Licence: TX W0015) | |
| 207R00000X Internal Medicine (Licence: LA 337143) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2026-04-09 |