| NPI | 1285253906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W0327) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01093548A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: IN 01093548A) | |
| 208000000X Pediatrics (Licence: TX W0327) | |
| 208D00000X General Practice (Licence: IN 01093548A) | |
| 207R00000X Internal Medicine (Licence: TX W0327) | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2025-09-10 |