| NPI | 1881344711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX W0632) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 2741) |
| 208000000X Pediatrics (Licence: TX W0632) | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-09-22 |