| NPI | 1073931234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2018-01421) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125065560) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2023-06-14 |