| NPI | 1003263195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 56189) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.136539) |
| 208M00000X Hospitalist (Licence: KY TP440) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2022-01-27 |