| NPI | 1801244918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS021163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS021163) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT017072) | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2021-05-24 |