| NPI | 1235524869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AR E-10391) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: AR E-10391) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2025-02-04 |