| NPI | 1619231826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX R4463) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 28907r) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2025-04-03 |