| NPI | 1467125732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V6362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V6362) |
| 208M00000X Hospitalist (Licence: MA 1019887) | |
| Enumeration Date | 2021-07-31 |
| Last Update Date | 2025-08-22 |