| NPI | 1306100912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T8099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 29003) |
| 208M00000X Hospitalist (Licence: IA MD-44926) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2023-02-08 |