| NPI | 1730509472 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R7937)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 305405)  | 
| 208M00000X Hospitalist (Licence: LA 305405)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-21 | 
| Last Update Date | 2023-02-07 |