| NPI | 1497139810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SD 12213) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 69470) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2021-02-16 |