| NPI | 1225483423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S7718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 57545) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2024-03-01 |