| NPI | 1245893049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T8371) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 75538) |
| 208M00000X Hospitalist (Licence: KY C2650) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-05-01 |