| NPI | 1487996427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NM A-20176-16) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM R06-2013) |
| Enumeration Date | 2013-03-16 |
| Last Update Date | 2018-03-17 |