NPI | 1033592720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS019556) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS019556) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-06-30 |
Last Update Date | 2021-02-05 |