| NPI | 1407409287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD477883) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125074088) |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2022-08-08 |