| NPI | 1659804987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W3293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX W3293) |
| 207R00000X Internal Medicine (Licence: MS 28897) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2026-04-21 |