| NPI | 1700445400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 88415) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT218023) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2023-04-20 |