| NPI | 1194139451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D86114) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD044904) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2018-10-12 |