| NPI | 1568604593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 006044)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 4992)  | 
| 208M00000X Hospitalist (Licence: OR DO160050)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-06 | 
| Last Update Date | 2025-06-05 |