| NPI | 1598899213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 17672) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 17672) |
| 207L00000X Anesthesiology (Licence: AZ 45442) | |
| 207R00000X Internal Medicine (Licence: AZ 45442) | |
| 207R00000X Internal Medicine (Licence: OH 35.091301) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV LL1567) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2023-03-07 |