| NPI | 1114337029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101259259) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: VA 0101259259) | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2021-07-26 |