| NPI | 1851903181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W0498) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY P106561) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX W0498) | |
| 208D00000X General Practice (Licence: NY P106561) | |
| 208M00000X Hospitalist (Licence: TN 73127) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2025-08-22 |