| NPI | 1891144317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2021024979) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: ME MD28008) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME MD28008) | |
| 207R00000X Internal Medicine (Licence: ME MD28008) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2024-06-15 |