| NPI | 1912143421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N3798) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX N3798) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2011-04-27 |