| NPI | 1902466352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T5536) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10067114) |
| 207R00000X Internal Medicine (Licence: TX T5536) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2022-09-20 |