| NPI | 1841553617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 52456) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 52456) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301101185) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-03-18 |