| NPI | 1588209258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-00800) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP04812) |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2024-02-21 |