| NPI | 1891953428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01080) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208M00000X Hospitalist (Licence: NC 2011-01080) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2013-09-30 |