| NPI | 1194258087 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A204272) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 61287) | 
| 207RR0500X Internal Medicine, Rheumatology (Licence: CA A204272) | |
| 208M00000X Hospitalist (Licence: AZ 61287) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP06098) | |
| Enumeration Date | 2017-04-06 | 
| Last Update Date | 2025-08-14 |