| NPI | 1043650302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 13957) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ND RL12883) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-06-07 |