| NPI | 1336587195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX Q9865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q9865) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT204596) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-03-25 |