| NPI | 1962855627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 74936) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 74936) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-12-01 |