| NPI | 1346479474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02004954A) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 36129147) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL PENDING) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2023-11-27 |