| NPI | 1063906790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 291133) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 276405) |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2023-04-24 |