| NPI | 1558776187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 321753) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME131577) |
| 208M00000X Hospitalist (Licence: LA 321753) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-12-20 |