| NPI | 1629344221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD455362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9580785-1205) |
| 208M00000X Hospitalist (Licence: UT 9580785-1205) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2020-10-30 |