| NPI | 1356733018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V3283) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V3283) |
| 207R00000X Internal Medicine (Licence: FL OS14187) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2025-06-25 |