| NPI | 1962866467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD488765) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 63160) |
| 207RN0300X Internal Medicine, Nephrology (Licence: TN 63160) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: PA MD488765) | |
| 207R00000X Internal Medicine (Licence: PA MD488765) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2025-10-09 |