| NPI | 1083142616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP61503041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO2759) |
| 207R00000X Internal Medicine (Licence: NC 2019-00906) | |
| 208M00000X Hospitalist (Licence: WA DO.OP.61503041) | |
| 208M00000X Hospitalist (Licence: NV DO2759) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2025-05-19 |