| NPI | 1285260240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 81230-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0067605) |
| 208M00000X Hospitalist (Licence: WI 81230) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2023-12-15 |