| NPI | 1023752201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116042532) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2024040374) |
| 207R00000X Internal Medicine (Licence: MO 2024040374) | |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2026-06-15 |