| NPI | 1942688023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX V5286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V5286) |
| 207R00000X Internal Medicine (Licence: AZ 59456) | |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2025-08-07 |