| NPI | 1255573697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 50740) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 050740) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2018-08-01 |