| NPI | 1295251031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 32539) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036171167) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2026-05-26 |