| NPI | 1962906370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2025-03676) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OR MD193568) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: OR MD193568) | |
| 207R00000X Internal Medicine (Licence: RI MD18220) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2026-01-28 |