| NPI | 1801152863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T5734) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036137670) |
| 207R00000X Internal Medicine (Licence: TX T5734) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2025-09-04 |