| NPI | 1548827090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101026728) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151013554) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2024-06-24 |