| NPI | 1770107617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 331349) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036172249) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2025-09-16 |