| NPI | 1578297842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.151918) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.252609) | |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2025-07-17 |