| NPI | 1316332109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101273970) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 68200-20) |
| 207Q00000X Family Medicine (Licence: WI 68200-20) | |
| 208M00000X Hospitalist (Licence: VA 0101273970) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-06-11 |