| NPI | 1376876078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35130610) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012027548) |
| 208M00000X Hospitalist (Licence: MO 2012027548) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-09-12 |
| Last Update Date | 2018-07-30 |