| NPI | 1487065900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 45517) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 52214) |
| 208000000X Pediatrics (Licence: SC 52214) | |
| 208M00000X Hospitalist (Licence: AL 45517) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2024-02-01 |