| NPI | 1205463817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V8989) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V8989) |
| 207R00000X Internal Medicine (Licence: FL ME159365) | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-10-07 |