| NPI | 1730600826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301507022) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301507022) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214453) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-05-27 |