| NPI | 1659833416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A196147) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.154877) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2026-06-11 |