| NPI | 1205222189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 83486) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: GA 83486) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2019-10-15 |