| NPI | 1164798534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q9287) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX G9287) |
| 207R00000X Internal Medicine (Licence: VA 0101251448) | |
| 208M00000X Hospitalist (Licence: MO 2016030288) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2025-09-29 |