| NPI | 1740509587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2024-0045) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: NY 271887) | |
| 208M00000X Hospitalist (Licence: MO 2016020761) | |
| 207R00000X Internal Medicine (Licence: MO 2016020761) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2026-01-29 |