NPI | 1396191565 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME144766) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME144766) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 4842940) | |
Enumeration Date | 2016-05-06 |
Last Update Date | 2025-10-02 |