| NPI | 1205571692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W8373) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R79491) |
| 207R00000X Internal Medicine (Licence: TX V8373) | |
| Enumeration Date | 2022-05-01 |
| Last Update Date | 2026-08-14 |