| NPI | 1235888116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MO 2025010699) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2025010699) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: MO 2025010699) | |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2026-06-30 |