| NPI | 1487273942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 331635) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 75364) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-08-19 |