| NPI | 1467806679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.148110) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD468962) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MD468962) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-07-06 |