| NPI | 1932788718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V2770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-17143) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2024-08-27 |