| NPI | 1972921054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V4911) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 33720) |
| 208M00000X Hospitalist (Licence: OK 33720) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2025-06-25 |