| NPI | 1558624619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101258450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D79952) |
| 207R00000X Internal Medicine (Licence: VA 0101258450) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC 00000000000) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2022-10-28 |