| NPI | 1538502745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 265311) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 265311) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 265311) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2019-05-28 |