| NPI | 1164711909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME138862) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NH LT4036) |
| 207R00000X Internal Medicine (Licence: IL 036.138383) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: CT 61933) | |
| 207RN0300X Internal Medicine Nephrology (Licence: IL 036.138383) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2019-01-28 |