| NPI | 1063823193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01080998A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 273044) |
| 208M00000X Hospitalist (Licence: MA 273044) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 272059) | |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2023-04-19 |