| NPI | 1528511268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 21322) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PR 21322) | |
| 208M00000X Hospitalist (Licence: PR 21322) | |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2022-04-04 |