| NPI | 1821502162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T6678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME161829) |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 16-469) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2023-08-10 |