| NPI | 1962810937 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 84304) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.134359) |
| 208M00000X Hospitalist (Licence: OH 35.134359) | |
| 208M00000X Hospitalist (Licence: WV 28006) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2025-02-11 |