| NPI | 1720492713 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: HI MD-22076) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A143227) | 
| 208M00000X Hospitalist (Licence: CA A143227) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-17 | 
| Last Update Date | 2022-07-25 |