| NPI | 1679215875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS025323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS025323) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2026-01-19 |