| NPI | 1568919512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 22222) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD477633) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2024-01-05 |