| NPI | 1093177131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 69062) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NV 24618) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-12-11 |