| NPI | 1245434612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.205258) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: AL MD.29294) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2012-10-25 |