| NPI | 1255838173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 92850) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11170900) | 
| 207R00000X Internal Medicine (Licence: PA MD477492) | |
| 208M00000X Hospitalist (Licence: PA MD477492) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT225312) | |
| Enumeration Date | 2018-04-08 | 
| Last Update Date | 2024-08-29 |