| NPI | 1659620417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 56188) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX Q4871) |
| 207R00000X Internal Medicine (Licence: TN 56188) | |
| 207R00000X Internal Medicine (Licence: OH 35.123519) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2018-11-20 |