NPI | 1417361452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101212476) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 290000) |
Enumeration Date | 2014-06-18 |
Last Update Date | 2022-06-13 |