| NPI | 1912109091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2008-00680) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN8976) |
| 207R00000X Internal Medicine (Licence: NC 2008-00680) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-01-22 |