| NPI | 1306467287 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301509081)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301509081)  | 
| 208M00000X Hospitalist (Licence: MI 5315239054)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-01 | 
| Last Update Date | 2023-06-27 |