| NPI | 1235524976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: RI MD17655) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 293021) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2021-07-03 |