| NPI | 1043557630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.132954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T4473) |
| 207R00000X Internal Medicine (Licence: PA MD451230) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2024-09-20 |