| NPI | 1164875902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U1019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 86507) |
| 208M00000X Hospitalist (Licence: MD D0091283) | |
| 208M00000X Hospitalist (Licence: CO DR.0062854) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2025-08-01 |