| NPI | 1306309273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 179761) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA PTL528) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2022-06-21 |