| NPI | 1982349098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V6861) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX V6861) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2025-08-20 |