NPI | 1578927653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 299866) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: NY 299866) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-05 |
Last Update Date | 2025-05-19 |