| NPI | 1750592887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61174497) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD440951) |
| 207R00000X Internal Medicine (Licence: WA MD61174497) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT188471) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-03-06 |