| NPI | 1336376920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 24663) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156811) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2022-04-05 |