| NPI | 1790308674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1013001) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 284543) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2023-04-20 |