| NPI | 1023560646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U5636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61256372) |
| 208M00000X Hospitalist (Licence: WA MD61256372) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2023-08-11 |