| NPI | 1982264453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2022-01893) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2022-01893) |
| 207R00000X Internal Medicine (Licence: NC 2022-01893) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2022-01893) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT019283) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2026-05-18 |