| NPI | 1376803437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 324895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2015-0617) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A147582) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2012-0502) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2023-07-31 |