| NPI | 1336587377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036153240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2016-02375) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-12-20 |