| NPI | 1821587429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 55398) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY TP970) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2021-06-29 |