| NPI | 1386022234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A165407) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 295788) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2020-12-18 |