| NPI | 1275198053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T3711) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T3711) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX T3711) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2022-12-21 |