| NPI | 1184185209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 84764) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD478991) |
| 207R00000X Internal Medicine (Licence: PA MD478991) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2026-06-22 |