| NPI | 1255015616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W5239) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10084422) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2026-05-04 |