| NPI | 1932620630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: IA DO-05593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA DO-05593) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2021-07-15 |