| NPI | 1962023564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071526) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U6060) |
| 208M00000X Hospitalist (Licence: TX U6060) | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2023-08-09 |