| NPI | 1730592189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 66483-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105025) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301105025) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-07-21 |