| NPI | 1518321694 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 299620) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2016-04-05 | 
| Last Update Date | 2021-12-27 |