| NPI | 1184955395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 54434) |
| Additional Taxonomies | 104100000X Social Worker |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2018-02-15 |