NPI | 1235629197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 324157) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 67609) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-05-16 |
Last Update Date | 2023-08-01 |