| NPI | 1639776917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OR MD214040) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2024-01-16 |