| NPI | 1801202783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R0385) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A148832) |
| 207R00000X Internal Medicine (Licence: IL 036.174799) | |
| 208M00000X Hospitalist (Licence: TX R0385) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2025-07-15 |