| NPI | 1780146258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NY 317683) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2023-06-16 |