| NPI | 1427739028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 78613) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL 38675) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2025-06-12 |