| NPI | 1669725073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 57045) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DC LPN1005980) |
| 208M00000X Hospitalist (Licence: MD D90379) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2024-11-13 |