| NPI | 1790160554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U2415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 30975) |
| 207R00000X Internal Medicine (Licence: TX U2415) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-09-19 |