| NPI | 1336274950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D0066184) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-05-27 |