| NPI | 1417189150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R4538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD457854) |
| 208M00000X Hospitalist (Licence: PA MD457854) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301093796) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2019-08-29 |