| NPI | 1861764441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 9431515-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: UT 9431515-8017) | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2017-04-25 |