| NPI | 1063096972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 8040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 8040) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2025-10-20 |