| NPI | 1700380557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME149890) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U0299) |
| 208M00000X Hospitalist (Licence: TX U0299) | |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2024-09-12 |