| NPI | 1760866297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C191877) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-46624) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125066784) | |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-02-16 |