| NPI | 1700306750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 63505) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019533A) |
| 207R00000X Internal Medicine (Licence: TN 63505) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |