| NPI | 1710273339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX S3307) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX S3307) |
| 208M00000X Hospitalist (Licence: IL 036.140476) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2021-04-20 |