| NPI | 1689195133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U1163) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX U1163) |
| 207R00000X Internal Medicine (Licence: VA 0101269440) | |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2026-09-03 |