| NPI | 1518615111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W4736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX W4736) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: VA 0102208859) | |
| 207R00000X Internal Medicine (Licence: VA 0102208859) | |
| Enumeration Date | 2022-03-13 |
| Last Update Date | 2026-07-20 |