| NPI | 1396135083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NE 29759) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135308) |
| 207R00000X Internal Medicine (Licence: NE 29759) | |
| 208D00000X General Practice (Licence: NE 29759) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2023-03-08 |