| NPI | 1912330200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX S5027) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036140593) |
| 207R00000X Internal Medicine (Licence: TX S5027) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2022-10-17 |