| NPI | 1477940658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A18260) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 20A18260) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 286997) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-07-12 |