| NPI | 1619683703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA DO-55462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 132180821-1224) |
| 208M00000X Hospitalist (Licence: UT 132180821-1224) | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2026-07-22 |