| NPI | 1124525084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD217996) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 64487) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-12-17 |