| NPI | 1104000496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V8628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD163113) |
| 207R00000X Internal Medicine (Licence: SC 32187) | |
| 208M00000X Hospitalist (Licence: OR MD163113) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2025-07-09 |