| NPI | 1588059877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301107390) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301107390) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2019-04-04 |