| NPI | 1770966962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 19528) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NH 19528) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2019-11-01 |