| NPI | 1275988511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME138698) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2019024536) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2020-10-19 |