| NPI | 1235628306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-01315) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-01315) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 238465) | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2021-08-16 |