| NPI | 1518492545 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL DO.2690) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL OS16767) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-27 | 
| Last Update Date | 2021-12-08 |