| NPI | 1306472287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 325327) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: NY 325327) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 325327) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2023-08-11 |