| NPI | 1831859479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: IL 125083129) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY P113517) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10085272) | |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2024-06-25 |