| NPI | 1467649830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 065602) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 29763) |
| 207R00000X Internal Medicine (Licence: TN 45291) | |
| 207R00000X Internal Medicine (Licence: KS 04-34597) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2023-11-14 |