| 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 |