| NPI | 1538666458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A188625) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NM MD2021-0887) | |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2024-12-03 |