| NPI | 1528794609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 22574) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 35126) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 35126) | |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2025-12-08 |