| NPI | 1912214818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01082828A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-40722) |
| 207R00000X Internal Medicine (Licence: IA 40722) | |
| 208M00000X Hospitalist (Licence: IA MD-40722) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301097309) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2025-08-11 |