| NPI | 1821483751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60760270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 12246329-1205) |
| 208M00000X Hospitalist (Licence: UT 12246329-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2022-12-20 |