| NPI | 1922686013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 1027925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.169890) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-07-13 |