| NPI | 1992968531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD450757) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD450757) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA mt191256) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2018-10-26 |