| NPI | 1235454745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 068820) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: VA 0116022713) | |
| 208D00000X General Practice (Licence: GA 068820) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2019-11-19 |