| NPI | 1013534643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS20206) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS20206) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT020425) | |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2023-07-07 |