NPI | 1164781936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-00016) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101257565) |
208M00000X Hospitalist (Licence: NC 2018-00016) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-05-14 |
Last Update Date | 2023-04-19 |