| NPI | 1225291420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 56108) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125055393) |
| 208M00000X Hospitalist (Licence: WI 56108-21) | |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2015-09-10 |