| NPI | 1316325608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 309637) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: NY 309637-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2021-06-21 |