| NPI | 1831694660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A165392) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 75788) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CO DR.0074505) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD61651857) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-25 |
| Last Update Date | 2025-03-17 |