| NPI | 1609256346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 264174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264174) |
| 208M00000X Hospitalist (Licence: MA 264174) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2018-03-17 |