| NPI | 1104389832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T4587) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX T4578) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2025-08-15 |