| NPI | 1063156461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 14205108-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 14205108-1205) |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2025-05-21 |