| NPI | 1588195473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 61045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 64242) |
| 207R00000X Internal Medicine (Licence: AZ 61045) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2020-09-17 |