| NPI | 1730615873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S9638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 305591) |
| 207R00000X Internal Medicine (Licence: TX S9638) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-08-19 |