| NPI | 1578852976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL 47192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 47192) |
| 207R00000X Internal Medicine (Licence: CA A125504) | |
| 208M00000X Hospitalist (Licence: TX Q9379) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2023-09-15 |