| NPI | 1952754210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 299488) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211348) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2021-08-24 |