| NPI | 1710514427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 04-49661) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-49661) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KS 04-49661) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2023043681) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-06-19 |