| NPI | 1811263411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101259674) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101259674) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH R4091) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2024-05-30 |