| NPI | 1306200290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 61034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-01429) |
| 208M00000X Hospitalist (Licence: NC 2019-01429) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2023-09-18 |