| NPI | 1972244929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 14203517-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 14203517-1205) |
| 207R00000X Internal Medicine (Licence: CA A189549) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-01-08 |