| 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 | 2013-09-04 |