| NPI | 1194135939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 95074) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IN 01081564A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 272388) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2023-09-18 |