| NPI | 1154703957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1016466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME MD22517) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT208373) | |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2024-01-26 |