| NPI | 1699023200 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S0020) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2014-1009) | 
| 208M00000X Hospitalist (Licence: NM MD2014-1009) | |
| Enumeration Date | 2012-08-29 | 
| Last Update Date | 2024-07-30 |