| NPI | 1720541378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V6918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V6918) |
| 208000000X Pediatrics (Licence: TX V6918) | |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2026-04-29 |