| NPI | 1619382785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME130455) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ZZ TRN20282) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2020-07-08 |