| NPI | 1831585744 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 35134) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 80831) | 
| 207R00000X Internal Medicine (Licence: TX V0962) | |
| 208M00000X Hospitalist (Licence: TX V0962) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-08 | 
| Last Update Date | 2025-08-12 |