| NPI | 1750856902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V0409) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V0409) |
| 207R00000X Internal Medicine (Licence: MI 4301504750) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.246895) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2025-05-12 |