| NPI | 1295963528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102203174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203174) |
| 208M00000X Hospitalist (Licence: VA 0102203174) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2023-01-03 |