| NPI | 1225247018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11922196-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 11922196-1204) |
| 208000000X Pediatrics (Licence: MA 246441) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2026-08-11 |