| NPI | 1861913931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S8001) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S8001) |
| 207R00000X Internal Medicine (Licence: MI 5315087903) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-05-03 |