| NPI | 1013250992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-00595) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125064058) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2021-05-27 |