| NPI | 1609221365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 91488) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 91488) |
| 208D00000X General Practice (Licence: PA OS020282) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT018109) | |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2024-11-02 |