| NPI | 1588026470 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 312147) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 207R00000X Internal Medicine (Licence: LA 312147) | |
| Enumeration Date | 2016-03-22 | 
| Last Update Date | 2019-08-01 |