| NPI | 1578815957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101271978) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 16988) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2022-07-21 |