| NPI | 1235628025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.146271) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2023-06-05 |