| NPI | 1972243566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A208839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036171940) |
| 208M00000X Hospitalist (Licence: IL 036171940) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2026-04-24 |