| NPI | 1609495530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: IL 036171857) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: TX U8419) | |
| 208D00000X General Practice (Licence: TX U8419) | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2024-09-17 |