| NPI | 1235690256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 22352) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NH 22352) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 244202) | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-08-01 |