| NPI | 1235587312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 299890) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN32258) |
| 207R00000X Internal Medicine (Licence: WI 71163) | |
| Enumeration Date | 2016-05-30 |
| Last Update Date | 2023-10-28 |