| NPI | 1316500176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 69231) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: VA 0101286532) | |
| 208M00000X Hospitalist (Licence: NY 317014) | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-09-05 |