| NPI | 1144407123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR DO150463) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT011372) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2011-03-25 |