| NPI | 1982005450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 293444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 64932) |
| 208M00000X Hospitalist (Licence: PA MD461462) | |
| 208M00000X Hospitalist (Licence: CT 064932) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2022-09-12 |