| NPI | 1215432661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME148070) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 74631-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-01-18 |