| NPI | 1801423173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101274388) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101274388) |
| 208M00000X Hospitalist (Licence: FL ME169796) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-10-17 |