| NPI | 1780263368 |
|---|---|
| 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: CA A194254) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-09-13 |