NPI | 1386008563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS15733) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN E575075351117) |
Enumeration Date | 2016-04-13 |
Last Update Date | 2021-06-05 |