| NPI | 1811457559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A184127) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: IL 036.159858) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-03-17 |