| NPI | 1255866802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 96069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 43340) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AL 43340) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2024-03-27 |