| NPI | 1396368841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 77638) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 74104) |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2024-08-06 |