| NPI | 1386008563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL OS15733) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 18950) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN E575075351117) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2025-04-11 |