| NPI | 1114272432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 0055563) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT201648) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2025-12-11 |