| NPI | 1376922930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 67571) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.145161) |
| 208M00000X Hospitalist (Licence: ND 17068) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2021-06-02 |