| NPI | 1073740015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.204998) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: LA MD.204998) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2017-04-04 |