| NPI | 1902830243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: UT 8661504-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 11909) |
| 208M00000X Hospitalist (Licence: UT 8661504-1205) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-02-25 |