| NPI | 1255827085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 74189) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 74189) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 7141-851) | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2022-04-29 |