| NPI | 1376926378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: RI MD16951) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301108272) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2025-09-26 |