| NPI | 1093495947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 61674) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.082542) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2026-06-12 |