| NPI | 1588622088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 215714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 215714) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2011-07-13 |