| NPI | 1346610722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 202000784) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107901) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2023-04-19 |