| NPI | 1174776306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK MEDS7593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK MEDS7593) |
| 208000000X Pediatrics (Licence: AK MEDS7593) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2024-05-07 |