| NPI | 1336550946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 10821649-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 1336550946) |
| 208000000X Pediatrics (Licence: AZ 1336550946) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2022-05-23 |