| NPI | 1659783892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD475684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.130932) |
| 207R00000X Internal Medicine (Licence: IN 01090535A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2023-07-17 |