| NPI | 1639790223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.43253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 43253) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2025-02-10 |