| NPI | 1003496597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.171260) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 81553-21) |
| 207R00000X Internal Medicine (Licence: WI 81553-21) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2025-06-16 |