| NPI | 1215367008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101260734) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: VA 0101260734) | |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2021-08-30 |