| NPI | 1922461581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD465501) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: PA MD465501) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-02-09 |