| NPI | 1528646189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 81227) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WI 81227) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: WI 81227-20) | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2026-07-23 |