| NPI | 1619224615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD459407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-9320) |
| 208M00000X Hospitalist (Licence: MN 62326) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2022-07-21 |