| NPI | 1699024323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD445256) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD455256) |
| 282N00000X General Acute Care Hospital (Licence: PA MD455256) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2019-12-12 |