| NPI | 1700299294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD179498) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG168742) |
| 207R00000X Internal Medicine (Licence: OR MD179498) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2017-05-01 |