| NPI | 1649633462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MO 2025028192) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2025028192) |
| 207P00000X Emergency Medicine (Licence: IL 36148680) | |
| 207R00000X Internal Medicine (Licence: MO 2025028192) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2025-08-29 |