| NPI | 1740696640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 009054) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60845594) |
| 207R00000X Internal Medicine (Licence: AZ 009054) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR PG177800) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2022-11-29 |