| NPI | 1912644279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V8916) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX V8916) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2025-07-25 |