| NPI | 1639630379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS18798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS18798) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO6496) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2022-08-08 |