| NPI | 1184001703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 21567) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D85526) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD P31347) | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2022-08-17 |