| NPI | 1083077549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 19117) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2019-04-02 |