| NPI | 1083024459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT205942) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: OH 130372) | |
| 208M00000X Hospitalist (Licence: OH 130372) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2017-04-13 |