| NPI | 1033412218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 279267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD040705) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 279267) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2018-10-18 |