| NPI | 1639699242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 54127) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY TP306) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2022-07-21 |