| NPI | 1174914329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 65154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101261486) |
| 207R00000X Internal Medicine (Licence: FL ME138756) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2022-03-31 |