| NPI | 1487215950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301507530) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MI 4301507530) |
| 208D00000X General Practice (Licence: MI 4301507530) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 320211) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-07-18 |