| NPI | 1033559869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD186971) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG178578) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2018-07-05 |