| NPI | 1174906374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0026008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 310564) |
| 208M00000X Hospitalist (Licence: DE C1-0026008) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107726) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-05-08 |