| NPI | 1508266727 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A14761) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A14761) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-25 | 
| Last Update Date | 2023-03-06 |