| NPI | 1043622244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301105808) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2018-05-07 |