| NPI | 1184043069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.38295) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35132876) |
| 207R00000X Internal Medicine (Licence: AL 38295) | |
| 208000000X Pediatrics (Licence: OH 35.132876) | |
| 208000000X Pediatrics (Licence: AL MD.38295) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-02-01 |