| NPI | 1518196856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME128711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10033953) |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO 2013026071) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2012008070) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2023-06-22 |