| NPI | 1720379142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 78867) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.124171) |
| 207R00000X Internal Medicine (Licence: TN 2986) | |
| 208M00000X Hospitalist (Licence: TN 2986) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2023-03-05 |