NPI | 1376127647 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036168363) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036168363) |
207R00000X Internal Medicine (Licence: IL 125.078310) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-05-12 |
Last Update Date | 2024-02-28 |