| NPI | 1437895513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-06947) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151015699) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2025-09-17 |