| NPI | 1811339054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-9994) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 39696) |
| 208M00000X Hospitalist (Licence: OK 39696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2024-07-16 |