| NPI | 1720405038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R7449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301507906) |
| 208M00000X Hospitalist (Licence: OH 130422) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-04-22 |