| NPI | 1811337504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q7660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q7660) |
| 207R00000X Internal Medicine (Licence: AZ R74110) | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2025-09-29 |