| NPI | 1538545918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 93505) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 14909) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ND RL13634) | |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2022-12-23 |