| NPI | 1053800474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-02553) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 238191) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2022-10-20 |