| NPI | 1700376373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V6170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 56277) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2025-05-30 |