| NPI | 1316407745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2022-0091) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE 34341) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-03-01 |