| NPI | 1154853760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD194154) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101287145) |
| 207Q00000X Family Medicine (Licence: VA 0101287145) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2026-01-20 |