| NPI | 1114677051 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 13510291-1205) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 13510291-1205) | 
| Enumeration Date | 2022-03-24 | 
| Last Update Date | 2025-05-21 |