| NPI | 1164861043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 66418) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 66418) |
| 207R00000X Internal Medicine (Licence: MI 4301103688) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: WI 66418) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103688) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2023-05-26 |