| NPI | 1891147732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS18171) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 66527) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2021-09-20 |