| NPI | 1932411865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-40727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 40727) |
| 207R00000X Internal Medicine (Licence: IA MD-40727) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 22546) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2017-11-09 |