| NPI | 1285977413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA MD466865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME135252) |
| 207R00000X Internal Medicine (Licence: PA MD466865) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2022-10-13 |