| NPI | 1568844611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 080827) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 7686) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2020-05-22 |