| NPI | 1356901045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD478039) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT218132) |
| 207R00000X Internal Medicine (Licence: PA MD478039) | |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2022-08-12 |