| NPI | 1558636860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: IL 036147935) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: PA MD460252) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2020-04-02 |