| NPI | 1922520535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME142123) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.49296) |
| 208M00000X Hospitalist (Licence: FL ME142123) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2025-03-20 |