| NPI | 1235718289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MS 2932822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 2932822) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: NY 2932822) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2024-06-21 |