| NPI | 1811053812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CT 044822) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044822) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CT 044822) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2021-11-01 |