| NPI | 1487811899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME 122484) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: PA md450351) | |
| 207P00000X Emergency Medicine (Licence: PA md450351) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2015-07-02 |