| NPI | 1124423751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R1668) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R1668) |
| 208M00000X Hospitalist (Licence: TX R1668) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2022-12-07 |