| NPI | 1407141500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 02004428A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019463) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101019463) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2014-08-11 |