| NPI | 1871237834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 81680) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 9625) |
| 207Q00000X Family Medicine (Licence: WI 81680) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2025-06-10 |