| NPI | 1275199523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PR 21477) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14916-I) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-08-02 |