| NPI | 1134680895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-02491) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 88844) |
| 207R00000X Internal Medicine (Licence: TN 4852) | |
| 207R00000X Internal Medicine (Licence: NC 2023-02491) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-10-11 |