| NPI | 1093203259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 101756) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT MED-RES-LIC-67438) |
| 207Q00000X Family Medicine (Licence: MT 101756) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2021-09-17 |