| NPI | 1164651600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 52541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 104504) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: MN 52541) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2020-11-10 |