| NPI | 1184001976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX V1098) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME142396) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A176916) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2024-08-02 |