| NPI | 1629293212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 31634) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: SC TL31634) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-10-19 |