| NPI | 1386765105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 20512) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 7942612-1205) |
| 207R00000X Internal Medicine (Licence: NV 20512) | |
| 208600000X Surgery (Licence: MN 49828) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208600000X Surgery (Licence: UT 7942612-1205) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-11-25 |