| NPI | 1215907167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 038239) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 038239) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 038239) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-07-21 |