| NPI | 1164781936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-00016) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: VA 0101257565) | |
| 208M00000X Hospitalist (Licence: NC 2018-00016) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2024-09-09 |