| NPI | 1063897395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID O-1258) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 6278) |
| 207R00000X Internal Medicine (Licence: OK 6278) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2021-08-30 |