| NPI | 1003121930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 295429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01079155A) |
| 208M00000X Hospitalist (Licence: MA 295429) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2010021662) | |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2024-11-08 |