| NPI | 1609371137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NY 320620) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: HI MD-21740) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2023-09-08 |