| NPI | 1376216200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301511296) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: MI 4301511011296) | |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-02-24 |