| NPI | 1497106512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 82868) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2019-0570) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019067A) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2024-04-23 |