| NPI | 1003558198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD491268) |
| 208M00000X Hospitalist (Licence: PA MD491268) | |
| 208600000X Surgery (Licence: IL 125.080058) | |
| Enumeration Date | 2022-04-10 |
| Last Update Date | 2025-10-17 |