| NPI | 1659768133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024003149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 201802378520) |
| 207R00000X Internal Medicine (Licence: AL MD.42376) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2024-05-02 |