| NPI | 1205195096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD467420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE 1205195096) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2023-01-30 |