| NPI | 1700552577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 346233) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NY 346233) | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2026-07-30 |