| NPI | 1811484165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 87791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 89603) |
| 208M00000X Hospitalist (Licence: GA 89603) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2023-05-22 |