| NPI | 1184034159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 16435) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NV 16435) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-30 | 
| Last Update Date | 2024-10-30 |