| NPI | 1457779514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60850374) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 304741) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2024-02-15 |