| NPI | 1790162790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 60124) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: CT 60124) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2018-05-30 |