| NPI | 1740507789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D0077371) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: Not Applicable) | 
| Enumeration Date | 2010-04-30 | 
| Last Update Date | 2015-06-11 |