| NPI | 1548557275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 48617) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098795) |
| 207P00000X Emergency Medicine (Licence: AZ 48617) | |
| 207R00000X Internal Medicine (Licence: AR E-11982) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-12-15 |