| NPI | 1073965042 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX T6490) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 303860) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-01 | 
| Last Update Date | 2022-05-05 |