| NPI | 1568993475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 76730) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: VA 0116030113) | |
| 207R00000X Internal Medicine (Licence: VA 0116030113) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-01-24 |