| NPI | 1578099669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A157154) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A157154) |
| 208M00000X Hospitalist (Licence: CA A157154) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2021-12-21 |