| NPI | 1710332416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61051666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME143297) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: WA MD61051666) | |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2021-04-15 |