| NPI | 1578877064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 62042) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 62042) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT197921) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2024-06-03 |