| NPI | 1104340066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U7506) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX U7506) |
| 207R00000X Internal Medicine (Licence: IL 125.071559) | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2024-07-03 |