| NPI | 1235491044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL os13244) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL os13244) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO3211) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2024-09-05 |