| NPI | 1942596077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 95112) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-14659) | 
| 207R00000X Internal Medicine (Licence: VA 0101257511) | |
| 208M00000X Hospitalist (Licence: FL ME136128) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-27 | 
| Last Update Date | 2025-04-18 |