| NPI | 1699234567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 79452) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 73060) |
| 207R00000X Internal Medicine (Licence: TX U8679) | |
| 208M00000X Hospitalist (Licence: MI 4301508223) | |
| 208M00000X Hospitalist (Licence: TX U8679) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-08-11 |