| NPI | 1578978383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0086383) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD D86383) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: MD D86383) | |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2026-03-12 |