| NPI | 1215450499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: RI MD17070) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT212862) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2020-09-28 |