| NPI | 1073811287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 13286) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301097596) |
| 207R00000X Internal Medicine (Licence: ND 13286) | |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2018-05-29 |