| NPI | 1407102338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C174653) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036137791) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125062462) | |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-04-20 |