| NPI | 1912468158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U0104) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI EMC0009502) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-07-27 |