| NPI | 1164884342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 19250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0067304) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2026-03-13 |