| NPI | 1124629605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2020-1187) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.072905) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2023-03-06 |