| NPI | 1306363940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 73333) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 1017285) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2023-12-22 |