| NPI | 1790163764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX R5302) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 1790163764) |
| 207R00000X Internal Medicine (Licence: TX R5302) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10052481) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2020-03-20 |