| NPI | 1780850214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-36109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P0139) |
| 207R00000X Internal Medicine (Licence: AZ 57645) | |
| 208M00000X Hospitalist (Licence: MO 2013002540) | |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2025-03-28 |