| NPI | 1508421306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 69949) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 69949) |
| 208M00000X Hospitalist (Licence: CT 69949) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2025-03-10 |