| NPI | 1134879430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036171043) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2025-05-29 |