| NPI | 1639321045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2012008178) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012008178) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 62624) | |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2024-03-26 |