| NPI | 1720344732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GU M-2218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD M84011) |
| 207R00000X Internal Medicine (Licence: OR MD176634) | |
| 208M00000X Hospitalist (Licence: GU M-2218) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2021-09-29 |