| NPI | 1720607104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T8766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T8766) |
| 208M00000X Hospitalist (Licence: TX T8766) | |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2026-04-27 |