| NPI | 1104212760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01084324A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: OH 35.134715) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-03-24 |