| NPI | 1780841833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101264200) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101264200) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116028144) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2023-06-19 |