| NPI | 1124292214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-88249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2012-00766) |
| 208M00000X Hospitalist (Licence: NC 2012-00766) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2020-10-28 |