| NPI | 1871120998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A21083) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: CA 20A21083) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-10-17 |