| NPI | 1235620824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 307642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 307642) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 307462) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-20 |
| Last Update Date | 2023-07-22 |